Intensive care medicine
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Intensive care medicine · Sep 2000
Randomized Controlled Trial Clinical TrialEffect of PEEP on work of breathing in mechanically ventilated COPD patients.
To study the effects of PEEP on the inspiratory work done per breath on the respiratory system (W(I,rs)) in patients with chronic obstructive pulmonary disease (COPD). ⋯ In COPD patients the application of PEEP levels close to PEEPi can substantially reduce W(I,rs) without promoting further dynamic pulmonary hyperinflation.
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Intensive care medicine · Sep 2000
Comparative StudyBactericidal/permeability-increasing protein (BPI) in sepsis correlates with the severity of sepsis and the outcome.
To compare the prognostic significance of bactericidal/permeability-increasing protein (BPI), group II phospholipase A2 (PLA2-II), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF), interleukin-8 (IL-8) and interferon-gamma (IFN) in terms of predicting severity of sepsis and outcome. ⋯ The BPI and BPI/neutrophil ratios may serve as adjunctive tools to illustrate the severity of sepsis. However, their predictive power for sepsis-related death was not comparable to that of SAPS II scores and IL-8.
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Intensive care medicine · Sep 2000
Early signs of critical illness polyneuropathy in ICU patients with systemic inflammatory response syndrome or sepsis.
To evaluate with electromyography the incidence and the time of appearance of neuromuscular abnormality in patients with systemic inflammatory response syndrome (SIRS) and/or sepsis. ⋯ Because neuromuscular abnormalities seem to develop earlier than previously reported, electroneuromyography should be used more frequently as a diagnostic test.
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Intensive care medicine · Sep 2000
Cortical arousal in critically ill patients: an evoked response study.
Assessing the level of sedation in critically ill patients remains a challenge for the intensivist in order to avoid over or under-sedation. Clinical scoring systems may fail in patients with concomitant neurological disorders or requiring muscle relaxants. We evaluated auditory (AER) and median nerve somatosensory evoked responses (MnSSER) in critically ill patients sedated with sufentanil and propofol, in order to quantify the level of sedation during therapeutic interventions. ⋯ Changes of AER or MnSSER waves indicated cortical arousal in ICU patients during nursing care and physiotherapy. Further studies with evoked responses are recommended to evaluate whether bolus injections of sedatives and/or analgesics reduce cortical arousal and thereby minimise the patient's stress during nursing care.
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Intensive care medicine · Sep 2000
Procalcitonin: a valuable indicator of infection in a medical ICU?
To assess the use of procalcitonin (PCT) for the diagnosis of infection in a medical ICU. ⋯ In this study, PCT and CRP had poor sensitivity and specificity for the diagnosis of infection. PCT did not clearly discriminate SIRS from sepsis or severe sepsis.